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swim has had insane insomnia for the past 3 days because EVERYTHING has stopped working!
Quetiapine (seroquel) 400 mgs, does nothing but make swim gain weight, so she went off them a few days ago. started on Eszopiclone (lunesta) at 4 mg. not even slightly sleepy, even after taking five of these. swim ended up taking 2 mg. of her clonazepam, only to realize that she's built up such a tolerance that this dose no longer works.

swim has been on zolpidem (ambien) many times - back in the day, 10 mg. would do the trick; got up to 20 mg., then stopped. heard about the cr preparation, and got a prescription for 12.5 mg. pills.

here's the question -

will swim be fine with 12.5 mg., since she hasn't taken ambien in a while? as in, does ambien tolerance decrease after not using the specific drug for a few months (even though swim has a very high tolerance for benzos and, evidently, lunesta)?

also:

swim read on the internet that ambien can be crushed and snorted for faster, more powerful results. would this work with cr? has anyone tried this?

sorry if this is the world's most boring post. just seeking some "expert" advice!

Mr. Hamster says he uses zolpidem (Ambien, Myslee, and others) regularly and has for many years without any sort of tolerance. He does find sometimes a higher than normal dose, like 15-20mg is sometimes required. If he awakes during the night he will sometimes take 5mg and go back to sleep.

Zolpidem has a relatively short half-life and is eliminated from the system fairly quickly.

The hamster has never experienced tolerance even over long-term use of zolpidem and has never experienced any cross tolerance issues with any other benzodiazapine he's been prescribed by his health care professional.

Sometimes, even though it's contraindicated, the hamster will have a glass or two of wine or beer before bed with his zolpidem. He in no way recommends this to any other hamsters or chinchillas out there who might be reading this, but it helps to send Mr. Hamster to sleep very quickly.

Additionally, the hamster can see no benefit from insufflating zolpidem which would probably hit like a freight train, in addition to the binders getting in his sinuses. Sometimes, he does let the tablet dissolve under his tongue in the buccal membrane. The veins passing under the tongue also have the added benefit of absorption which avoids first pass metabolism. This sometimes affects the hamster quickly as well, and he sometimes wakes up after about an hour or two still sitting at his keyboard.

As they say, for Mr. Hamster, it works like a dream.

Be safe, be well...

Post Quality Evaluations:

very good explanation of dosing with chemical and clearly his hamster was experienced. I learned from it

thanks for the quick reply - it's becoming clear that swim is in the middle of a manic episode, probably from stopping the seroquel. she's been bouncing off the walls all day, quick breathing, racing thoughts, the usual - but is running low on clonazepam, and stuck with the ambien.

the "under the tongue" idea sounds good, but would it work with the controlled release zolpidem? swim knows that the pill has two layers - would this affect efficiency?

as for snorting the pill, swim wouldn't mind being hit like a freight train if it means getting relief from jumpiness. still, would the time-release layer thing cause problems?

Dissolving under the tongue should work, even with the controlled release. If it doesn't, Mr. Hamster thinks crushing the tablet slightly and place the crushed bits under the tongue. The silly hamster says he actually likes the taste and sometimes chews the tablets.

Another option might also be to crush the tablet and dissolve/mix it in some juice or other tasty beverage to mask the taste. This will effectively nullify the time-release mechanism.

Try melatonin. It worked for SWIYs gf when she was in mania. BZ alpha 1 subunit agonists (ambiens effects and the partial effects of certain other meds) are not good for mania. Melatonin helped the most followed by kava (if enough was ingested. roughly 1500 mg of 30% kavalactone content pills) and this antihistamine anxiolytic/hypnotic used in psychiatry. I forget its name but its very potent sedative effects and would knock my gf out when she needed it the most. Most other meds were not helpful (xanax, trazadone).

my lab rat recommends switching between benzos, antihistimes, and Z drugs weekly. This should keep tolerance to all those drugs low. For example, one week use clonazepam or better yet temezapam or alprazolam for sleep. the next week use an antihistamine like promethazine or the seroquel. third week use zolpidem or eszopiclone.

My lab rat says usually only rat doctors prescribe drugs like that and getting a human to prescribe such an atypical dose regimen may be difficult.

Some xyrem (GHB) would more than likely work very well, but good luck getting a doctor to prescribe that.

my lab rat recommends switching between benzos, antihistimes, and Z drugs weekly. This should keep tolerance to all those drugs low. For example, one week use clonazepam or better yet temezapam or alprazolam for sleep. the next week use an antihistamine like promethazine or the seroquel. third week use zolpidem or eszopiclone.

My lab rat says usually only rat doctors prescribe drugs like that and getting a human to prescribe such an atypical dose regimen may be difficult.

Some xyrem (GHB) would more than likely work very well, but good luck getting a doctor to prescribe that.

actually, i think this is probably the best idea - although swim isn't crazy about the seroquel because it makes her go on a feeding frenzy and not fit into her clothes! the doc will only give swim clonazepam (actually, he refuses to write alprazolam scripts for anyone), but swim could easily alternate the klonopin with the ambien (if she hadn't whipped through her klonopin so fast - she's only prescribed 1 mg. a day, but ends up take 2 or 3, then taking nothing for a few days. doc's already got his eye on her, so no chance of a larger prescription, even though this is the only drug that actually calms swim down)

when swim found out about melatonin, she was through the roof with excitement and raced to the store to buy a bottle - absolutely nothing. swim also asked the doc about sleeping pills that aren't z drugs, and he said that they all work in a manner similar to melatonin, and that swim was beyond that.

despite advice (swim started checking out other sites), swim snorted the 12.5mg. cr. no results. took a second orally (was going to let it dissolve under tongue as per wanderer's post, or chew them, but totally forgot). still nothing. swim said what the hell and swallowed a third pill (should've dissolved but forgot!) and is finally starting to feel slightly tranquil. nothing near the drooling, head nodding, falling off bike affect that swim used to get from just 10 mg.

that's a ridiculous amount of pills. swims definitely going for the benzo/z-drug switch-off next script fill.

my lab rat recommends switching between benzos, antihistimes, and Z drugs weekly. This should keep tolerance to all those drugs low. For example, one week use clonazepam or better yet temezapam or alprazolam for sleep. the next week use an antihistamine like promethazine or the seroquel. third week use zolpidem or eszopiclone.

Swim thinks that rotation like this is a brilliant idea to keep tolerance down, since tolerance is what ends up making most drugs stop being useful (including sleeping drugs).

Swim thinks that rotation like this is a brilliant idea to keep tolerance down, since tolerance is what ends up making most drugs stop being useful (including sleeping drugs).

SWIM knows a hamster who knows a lot about benzodiazapines. The hamster was saying that while this might seem like or sound like a brilliant idea on the surface, it's really a dangerous thing to so.

Abrupt cessation of benzodiazapines can dramatically lower the seizure threshold and cause even other complications, including some which are life threatening.Benzodiazapines should never be halted cold. If a hamster or chinchilla does this they could risk their health or their life.Benzodiazapines are very powerful drugs and should not be taken lightly.

When one decides to terminate treatment with benzodiazapines, they should work closely with their health care professional to get on a proper schedule of slowly tapering down their dosage and frequency in order to minimize serious risk to their health or life. Complications can be deadly or debilitating.

If one is rotating medications, they should do so only under the advice of a health care professional and under their supervision because of the serious nature of benzodiazapine withdrawal. It can be worse than heroin for some.

Mr. Hamster wants to make sure all the friendly critters here are around to keep him company for many more days to come.

wanderer brings up a very serious and good point. However the OP already stated that they have run out of clonazepam and are waiting for a refill so apparently are not dependent. Zolpidem if taken once daily at night usually does not produce dependence.

Also, benzos usually take 2 weeks to cause dependance when taken everyday therapeutically. My lab rat thought switching off each week would prevent this.

Can anyone verify if my rats hypothesis is correct?

Maybe the OP could run this idea of alternation by their physician. The physician may feel comfortable giving weekly prescriptions so the OP is never in posession of all these powerful drugs at once, being that he is already suspicious of abuse.

My problem with this is follows. Novel benzodiazepine-like drugs are being developed which do NOT cause tolerance OR physical dependence (unless its the new partial BZ agonists which cause limited dependence issues). The way these new drugs work is by NOT acting on the BZ alpha 1 receptor subunit. Thats all ambien or other sedatives work on. Bzs work, in varying degrees, on a multitude of alpha receptors at the benzodiazepine subunit of the GABA A receptor. Benzodiazepines get a negative wrap even though there therapeutic effect in actuality doesnt decline unless someone is prone to drug addction/poly drug user (Meyer and Quenzer, 2005). In actuality, benzodiazepines carry limited abuse and dependence issues as the above mentioned sedatives. Its through BZ alpha 1 unit tolerance that people feel the need for more of those drugs for sedative effects and causes limited reinforcement.

Zolpidem and other drugs like it act through the same mechanisms through which BZs cause dependence and tolerance. Except there only mechanism of action is through that receptor subunit. For certain types of insomnia or insomnia brought on by anxiety/anxious thoughts, BZs remain the most effective because people do not gain tolerance to their anxiolytic effect mediated through other receptor subtypes (Meyer & Quenzer, 2005).

imyourlittlebare added 2 Minutes and 35 Seconds later...

Perhaps a reason the drugs arent working is because the person simply is not tired or poor health habits. Im the last one on this entire network to admit this, but if one exercises enough and avoids caffeine, does things to avoid mania, and tries a diet higher in tryptophan, this might help along with not trying to force going to sleep. Sleep when it feels right. Try to keep a consistent ritual (phone off, bedroom only for sex and sleep, no tv/videogames for several hours before bed and limit caffeine intake to before 2 or 3 pm).

Post Quality Evaluations:

thanks for linking sources

Last edited by imyourlittlebare; 06-12-2010 at 22:42.
Reason: Automerged Doublepost

wanderer brings up a very serious and good point. However the OP already stated that they have run out of clonazepam and are waiting for a refill so apparently are not dependent. Zolpidem if taken once daily at night usually does not produce dependence.

Also, benzos usually take 2 weeks to cause dependance when taken everyday therapeutically. My lab rat thought switching off each week would prevent this.

Can anyone verify if my rats hypothesis is correct?

Mr. Hamster cannot verify this for any other hamster for sure. It is an interesting question, and the curious hamster would like to know more about this from other lab rats out there. However, the OP's chinchilla isn't taking the dose as prescribed. Also diagnosis of this nature cannot be done easily through a forum, over the internet, by email, or telephone. The studies done on clonazepam during its clinical trials were a 9 week fixed dose trial as described here:

Quote:

Originally Posted by Klonopin Monograph

Study 1 was a 9-week, fixed-dose study involving Klonopin doses of 0.5, 1, 2, 3 or 4 mg/day or placebo. This study was conducted in four phases: a 1-week placebo lead-in, a 3-week upward titration, a 6-week fixed dose and a 7-week discontinuance phase.

These doses were titrated upwardly by between .125-.25mg per day until reaching the desired dose. This would be as the quote states upwardly increasing the dosage over three weeks, maintaining it for 6 weeks and titrating down over 7 weeks.

Now the OP stated their chinchilla was taking 1-3mg per day, and not as directed by their physician. This is a pretty large dose and if they are able to tolerate it, they may be messing with their seizure threshold, however, every hamster is different.

A second study was done in clinical trials using flexible dosing as follows:

Quote:

Originally Posted by Klonopin Monograph

Study 2 was a 6-week, flexible-dose study involving Klonopin in a dose range of 0.5 to 4 mg/day or placebo. This study was conducted in three phases: a 1-week placebo lead-in, a 6-week optimal-dose and a 6-week discontinuance phase. The mean clonazepam dose during the optimal dosing period was 2.3 mg/day.

So, the dose was increased during the course of a single week, and followed by a maintenance period of 6 weeks where the patient determined their optimal dose. This was then followed by 6 weeks of titrating back down.

The hamster would submit that starting with a huge dose of 1-3mg per day, and 3mg seems to from the literature be a rather high dose, might help build a tolerance faster, and have dependent effects like lowering the seizure threshold due to the long serum half-life of clonazepam which is 30-50 hours.

From this, Mr. Hamster seems to think clearing such a high body load would take a while, and one might feel rebound effects as well as the possibility of seizure.

Here's the recommended dosing for seizure disorder:

Quote:

Originally Posted by Klonopin Monograph

Seizure Disorders: Adults: The initial dose for adults with seizure disorders should not exceed 1.5 mg/day divided into three doses. Dosage may be increased in increments of 0.5 to 1 mg every 3 days until seizures are adequately controlled or until side effects preclude any further increase. Maintenance dosage must be individualized for each patient depending upon response. Maximum recommended daily dose is 20 mg.

Now this says that to control seizures, the maximum effective dose should probably not exceed 1.5mg/day.

For panic disorder it's a bit more complicated:

Quote:

Originally Posted by Klonopin Monograph

Panic Disorder: Adults: The initial dose for adults with panic disorder is 0.25 mg bid. An increase to the target dose for most patients of 1 mg/day may be made after 3 days. The recommended dose of 1 mg/day is based on the results from a fixed dose study in which the optimal effect was seen at 1 mg/day. Higher doses of 2, 3 and 4 mg/day in that study were less effective than the 1 mg/day dose and were associated with more adverse effects. Nevertheless, it is possible that some individual patients may benefit from doses of up to a maximum dose of 4 mg/day, and in those instances, the dose may be increased in increments of 0.125 to 0.25 mg bid every 3 days until panic disorder is controlled or until side effects make further increases undesired. To reduce the inconvenience of somnolence, administration of one dose at bedtime may be desirable.

Treatment should be discontinued gradually, with a decrease of 0.125 mg bid every 3 days, until the drug is completely withdrawn.

This indicates a maximum dose of 4mg per day. It also states that increasing the doses higher than the 1mg effective dose seemed less effective than the 1mg per day dose.

Also, sleep is a side-effect and according to the monograph the hamster has, which might be out-dated, it would seem that clonazepam for sleep would be an off-label use, and probably not the most effective use of this benzodiazapine. Ones with a shorter half-life and more potent like estazolam and etizolam are typically prescribed for sleep. They have half lives of 4-6 hours and are somewhat more potent than clonazepam. Clonazepam is more of a "maintenance" benzodiazapine which stabilizes mood or helps with seizure disorder over time.

Taking variable doses in random amounts varying between 1-3mg per day is probably playing hell with the GABA system and rendering the drug less effective, but that's the hamster's best guess. All hamsters are different.

Although the original post does not so much address the question of tolerance to zolpidem than the question of cross-tolerance between benzo and benzo-like drugs, I would like to leave a quick post regarding zolpidem tolerance, just for the record so to speak.

Bobbin, a friend of mine, has been slowly coming off high doses of venlafaxine XR (600mg/d) a short while ago. He tapered it down at 75mg/d per week, but after going from 75mg/d to 0, he experienced a moderate discontinuation syndrome ("moderate" compared to the horror stories floating around the net of people quitting venlafaxine) for about three to four weeks. One of the symptoms was a quite severe insomnia. He still had a script lying around for 30 x 10mg of zolpidem, which he had been given months earlier when he mentioned occasional mild sleeping problems (undoubtedly due to the high dose of venlafaxine) to his doctor, without actually wanting to get anything prescribed for it. He got the script nonetheless, but didn't take it to a pharmacy because he felt like he didn't need, and didn't want, to take zolpidem. Anyway, now, in venlafaxine discontinuation, he did need it, so he got the zolpidem. The first night, which was about day 7 of discontinuation syndrome, he started with 5mg before going to bed. He's a big fan of not taking more of a drug than necessary, so he wanted to see whether 5mg would do the job. It did not, so he switched to 10mg the next day, which did work. One night, in the third week of discontinuation, he even had to take an additional 5mg (so 15mg in total) to get to sleep, so he did develop a slight tolerance during that time.

Eventually, after almost four weeks without venlafaxine, symptoms subsided and he was able to get back to sleeping without a hypnotic. At that point, he started taking an MAOI (tranylcypromine, brandname Parnate in the US) as the n-th drug for treating his depression. MAOIs are notorious for causing insomnia, especially during the first weeks after starting it. So, predictably, he newly started to have insomnia a little more than a week into the MAOI. Again, he wondered whether, this time, maybe 5mg would do the job - and they did. He has been taking 5mg of zolpidem at bedtime for the past five days, and it still works.

Thus, my friend concluded that, for him at least, zolpidem tolerance does build up even within the maximum 14 days of consecutive use that one is supposed to stick to, but tolerance decreases even faster, to the point where, a little more than a week after stopping to take it, it was like tolerance was completely gone.

it's becoming clear that swim is in the middle of a manic episode, probably from stopping the seroquel.

I just realised this part of what the OP said. It seems likely that stopping Seroquel abruptly would have caused this mania-like reaction and sleeplessness as suggested.

If the manic state remains, then temporarily going back on Seroquel and then slowly reducing the dose could help. Starting a mood stabiliser could be another answer if a manic state is causing serious lack of sleep.

SWIM used to be one decent Zolpidem junkie for about one and a half years, taking it before going on alcohol binges. The maximum he/she ever took back then in one evening was exactly 6.5 (with alcohol of course). SWIM even had pet names and poetry for the white beauties! The first experience on half a Zolpidem, SWIM wrote down. It was quite a hilarious text as a long line of ink stretching from the middle of a word indicated the end of that evening's writing. SWIM lasted about 20 minutes on half a pill that first time. All was well until a vaguely remembered $2500 incident after which SWIM decided to quit.

About 4 years later, life happened and SWIM found him/herself back on the Zolpidem. That first taste of bitterness brought back the lovely memories (or lack thereof...) and SWIM got back into party mode, not time-for-bed mode. SWIM found that he/she could stay awake indefinitely if he/she had a steady supply of Zolpidem (had parties till 5/6am or later on only Zolpidem and Coca-Cola - nothing else!). It should be noted that SWIM used both Zolpidem and Imovane, but primarily Zolpidem.

Point being, SWIM therefore always assumed that Zolpidem is one of those drugs where one never loses tolerance. However this is contradictory to the observations of previous posters. Could a placebo effect really be able to make a junkie live a "normal" life while he/she struggled to control his/her intake even with a steady supply of 150 pills per month??

Some might be happy to know that last time I heard, SWIM quit the pills abruptly! (And is still alive!) I would like to add that I personally would not recommend anybody following the irresponsible past behaviour of this person I have heard about.

Swim had 3 day insomnia due to anxiety, and she was put on trazodone 150mg very powerfull. few down sides, heavy sleep, hard to wake up during sleep and druged feeling when you do wake up, acts like sadation for Swim, big pill. Impossible to fight as first sign of kickin in (immediate release) in swim is little equilibrium, very dizzy , and the intense need to lay down as eye lids are heavy. wakeing up noy tired, definatly outweighs the downsides.

on the earlier post, my cat, when he is having a very rough night/crash, and needs sleep immediately/as soon as possible, or to deal with rough anxiety and nothing else to stop it, has snorted ambien ir. from doses of 10 mg to 30 mg. 10 mg is effective and messes my cat up a decent but manageable amount, while 30 mg is definitely significant

my cat can't speak to if its the most effective method, but notices effects in 2 minutes. while my cat also gets effects from ambien orally in 5 minutes, the effect builds up over a half hour, where as insufflating seems to provide an instant peak of effects

ambien works wonderfully for my cat, and is a drug he only takes occasionally, and he has taken many other much more euphoric, sedating, and visually interesting drugs, but in a way my cat actually thinks ambien might be his favourite. its a unique, strange feeling that he hasn't gotten from anything else, ever, and it gives him no side effects and no hang over what so ever. he's also never had a bad experience on it emotionally, and he's never sleep walked. he's in pretty good control of his actions as well; his motor skills and coordination is off, and he is a bit more lovey dovey and definitely acts weird, but he knows that if he does something that he might regret later, that its something he might regret later

my cat is sorry to hear about your trouble with ambien. my cat really thinks that talking to a doctor is the best option. my cat has had to attend a rehab facility before, and the cats addicted to ambien were, honestly, almost as much of a mess or more, and actually more dependent on their drug than the functional heroin addicts in there. my cat has no problem with it, but for some people, playing around with doses is a really dangerous decision

also, on mr hamsters earlier post about combining it with alcohol, my cat knows some people who this is an awful idea for, and either sedates them far too quickly, or causes them to sleepwalk extensively. my cat personally finds that adding 2 or 3 shots, at most 6 to a dose of 10-20 mg heightens the effect of both significantly, causing him to have a very good time but to black out most of the night, which hoenstly doesn't bother my cat too much

this doesn't effect all cats the same way, and my cat wouldn't at all suggest anyone do it. just sharing an anecdote

For swim who was on zopiclone (nearly the same as zolpidem) 3x7.5mg nightly which equals 22.5mg got some tolerance issues

What swim did was stop for only 4 days and went running as hard as he could for 40mins on those 4 days and result was tolerance dropped and zopiclone started working great again but swim is more carefull with it now.

warning though in the 4 days off it was horrible but if you can have a 'ready for anything' 'Utrinque Paratus' attitude its a piece of piss. Now swim goes running weekly to stay fit and swim swears it helps with sleep.

The cat finds that tolerance to Z-drugs (Ambien, Zopiclone etc) becomes significant after nine days. However IF she takes two nights out (during which she doesn’t go to sleep at all, avoids any alcohol, caffeine or excitement, doesn’t go into work AND keeps perfect sleep hygiene practices) they will work for another week after that. Then she's fucked.

She has always found that using Z-drugs after drinking alcohol is a really bad idea, as then they don’t work properly and give her horrible sleep paralysis-type experiences. (It must depend on an individual's body chemistry.)

Atomic Dog added 2 Minutes and 31 Seconds later...

Doh! Atomic Dog forgot to say that the cat normally uses the recommended doses (3.75 to 7.5 Zopiclon, or equivalent of other Z-drugs)

swim read on the internet that ambien can be crushed and snorted for faster, more powerful results. would this work with cr? has anyone tried this?

sorry if this is the world's most boring post. just seeking some "expert" advice!

My friend Baby Jesus stole some of my ambien prescription and insufflated 10mg zolpidem with well great drunken happiness but woke up on the floor with no real recollection of the previous night. I believe he did this more than once with similar results, much more intense but the whole black out thing and sorta groggy, mentally slow hangover the next day was not as enjoyable.